Life and death, and the importance of each, are the prevailing themes throughout the stories in The Largesse of the Sea Maiden. Denis Johnson himself was grappling with the meaning of life in the face of his own impending death while writing these stories, and that perspective colors each of them.

Throughout the first story, which shares its name with the title of the collection, the main character, Bill Whitman, seems trapped and stagnant in his life in San Diego. He reveals that the majority of his former colleagues have all gone on to better careers and that he is on his third marriage. He enjoys a brief respite during his time in New York, which, while hectic and chaotic, helps him feel renewed and excited while he is there. When he returns, however, he comes back to a monotonous existence.

The second story, "Starlight in Idaho," is chaotic and delusional, exploring an alcoholic who muses that he may himself be the second coming of Christ before coming down to reality after taking his medication. Resulting from his therapy and the experiences that drove him nearly insane, he searches for God and turns to religion to stabilize and correct his life.

"Strangler Bob" explores the lives and actions of several young convicts who were involved in petty crimes in their youth. They are told while they are in prison that they'll all turn out the same, as murderers, and eventually their poor decisions lead them all down the path toward death.

"Triumph Over the Grave" shows a caretaker supporting many dying patients. He fights through potential heartbreak when listing off the many people he knew who had passed away under his watch, and he explicitly discusses his thoughts on how meaningless death is because life never ceases to continue even when we pass on and are forgotten.

The final story, "Doppelganger, Poltergeist," explores life and death through Mark Ahearn and his obsession with conspiracy theories revolving around covering up deaths as shameful and falsely perpetuating a person's life. He believes Elvis died young and was replaced by a twin, and later believes that the main character, Kevin, is the reincarnation of Ahearn's own deceased brother. His obsession parallels Johnson's focus on death and if it's possible to escape it or come back in some form after we pass away.